Vasculitis Flashcards
Vasculitis is inflammation of what?
Blood vessels
Which blood vessels does vasculitis affect?
Any
Which type of vasculitis has the worst prognosis?
Small vessel
What can cause secondary vasculitis?
Infection, drug, toxin, cancer
Vasculitis causes systemic symptoms e.g. fever, weight loss, fatigue. True or false?
True
What are the 2 types of large vessel vasculitis?
Takayasu Arteritis
Giant cell arteritis
Which type of large vessel vasculitis affects those < 40 and is more common in females?
Takayasu Arteritis
What race is Takayasu arteritis more common in?
Asians
Which type of large vessel vasculitis affects those > 50?
Giant cell arteritis
What vessel is most often involved in giant cell arteritis?
Temporal artery
Temporal arteritis has an association with which other condition?
Polymyalgia rheumatica
What is the major risk of temporal arteritis?
Blindness
If there are symptoms of temporal arteritis, what test should you do? Should you always discount it if it comes back negative?
Temporal biopsy- there may be skip lesions so do not discount if negative
What is the main treatment for giant cell arteritis?
Steroids (can consider sparing agents)
What is the starting dose of steroids for giant cell arteritis?
40-60mg
What are the two types of medium vessel vasculitis?
- Kawasaki Disease
- Polyarteritis Nodosa
Who is Kawasaki disease seen in?
Children under 5
What are the most important vessels to consider in Kawasaki Disease?
Coronary arteries
Where in the vessels does polyarteritis nodosa affect?
Vessel bifurcations
What other systems can polyarteritis nodosa affect?
Skin, gut, kidneys
What condition is polyarteritis nodosa associated with?
Hep B
Granulomatous inflammation of the respiratory tract, small and medium vessels. Necrotising glomerulonephritis is common. What condition is this?
Granulomatosis with polyangiitis
Eosinophilic granulomatous inflammation of the respiratory tract, small and medium vessels. Associated with asthma. What condition is this?
Eosinophilic Granulomatosis with Polyangiitis
Necrotising vasculitis with few immune deposits, necrotising glomerulonephritis is common. What condition is this?
Microscopic Polyangiitis
Which sex is GPA more common in?
Males
What is the typical age onset of GPA?
35-55
Saddle nose is associated with which condition?
GPA
EPGA is associated with asthma development when?
Later in life
Which cases of vasculitis are ANCA +?
GPA
EPGA
MP
Which subtype of ANCA is associated with GPA?
cANCA
Which subtype of ANCA is associated with EGPA?
pANCA
Does ANCA vary with disease activity?
Yes
What happens to complement during disease activity?
Levels fall
What is the treatment for localised and early systemic ANCA associated vasculitis?
Methotrexate and steroids
What is 1st line treatment for generalised and systemic ANCA associated vasculitis?
Cyclophosphamide and steroids
What is 2st line treatment for generalised and systemic ANCA associated vasculitis?
Rituximab and steroids
What is the treatment for refractory ANCA associated vasculitis?
IV immunoglobulins and rituximab
What usually precedes Henoch-Schonlein purpura?
UTI, pharyngeal or GI infection
What is usually the cause of Henoch-Schonlein purpura?
Group A strep
